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Call me a dreamer

As March is National Bed Month in the UK, we’re turning our attention to sleep, with a closer look at its importance for overall health and wellbeing.

Sometimes it feels like there’s nothing better in life than a good night’s sleep. It’s great to wake up feeling refreshed and energised, full of enthusiasm for the day ahead. Conversely, waking up knowing you haven’t slept well can have precisely the opposite effect. 

The Sleep Charity – one of the partners involved in National Bed Month – has launched a campaign to tackle ‘sleep poverty’. This includes people who are lacking a proper bed, bedding and suffering from poor sleep as a result. “Not only is it important to highlight issues around bed poverty but we also believe that everyone deserves access to other essential products that help them to achieve a better night’s sleep,” says the charity.

Initially running in the South Yorkshire area, the charity hopes to expand it across the UK but there are many ways pharmacy teams can start to help. Raising awareness about the importance of sleep and the devastating impact sleep poverty can have is a great place to start, especially as the cost of living crisis continues.

Sleep is vital 

A poor night’s sleep can leave us feeling forgetful, stressed, irritable and less able to concentrate. But alongside this, research shows that disrupted sleep can have a range of longer lasting negative impacts. 

Poor sleep has been shown to increase the risk of a range of chronic illnesses, including high blood pressure, diabetes, depression, cancer, heart attack and stroke. People who don’t get enough sleep are also more likely to be obese, possibly because shortened sleep affects the hormones that regulate hunger and appetite. 

In older people, poor sleep may accelerate cognitive decline and, according to the Royal Society for Public Health (RSPH), it can even make it harder for people of all ages to stop smoking. 

“Insufficient sleep may make it difficult for a smoker to abstain by impairing attention and cognition, changing cravings, affecting mood or increasing the reward value of cigarettes, and is therefore among the factors that make people more likely to relapse in tobacco treatment programmes,” says the organisation. 

Sleep sufferings

Insomnia

Persistent insomnia is thought to affect approximately 10-15 per cent of the adult population, and around 25 per cent of older adults

Sleep-related breathing disorders

Such as obstructive sleep apnoea, which is becoming increasingly common, possibly due to our ageing population and the increase in obesity

Hypersomnolence

Excessive sleepiness

Sleep-wake disorders

Such as shift work disorder and free-running sleep (getting later night on night).

Sleep-related motor disorders

Such as restless legs syndrome, bruxism (teeth grinding), and leg cramps.

Parasomnias

These include sleepwalking, night terrors, and recurrent and distressing nightmares. 

Outside of this, there is a general trend for people simply not to get enough sleep on a regular basis. RSPH research shows that many people are under-sleeping by roughly an hour each night, which adds up to a sleep deficit of around one full night every week.

What's your slumber number?

The Royal Society for Public Health believes a government-promoted ‘slumber number’ would be an important step towards improving public health. Here is its guide to roughly how much sleep everyone should be aiming for:

Age group (years) Hours' sleep per day (slumber number)
One to two 11-14
Three to five 10-13
Six to 13 Nine to 11
14-17 Eight to 10
18-25 Seven to nine
26-64 Seven to nine
65+ Seven to eight

What can be done?

This time last year, the Nytol brand joined forces with Mental Health UK to raise awareness of the need for better sleep, and to highlight the connection between sleep and mental wellbeing. Their campaign pointed out that with the clocks ‘springing’ forward in March each year, it’s a great time for us to reset our body clocks too.

Anant Naik, Mental Health UK spokesperson, said: “The days become longer, and spring is often associated with new beginnings. The key is to make any changes to your sleeping habits gradually and in a way that works for you, rather than a total overhaul.” 

Make a positive change

Have a consistent sleep schedule

Go to bed and wake up at the same time each day

Create a personalised bedtime routine to help unwind

Try a warm bath, read a book, practise mindfulness meditation or listen to a relaxing podcast.

Switch off electrical devices an hour before bed

Particularly the news. Bright lights before bed can stimulate us, interfering with our circadian rhythms (the body’s 24-hour internal cycles, which include the sleep-wake cycle).

Get outside

Exposing the body to natural light helps to keep the circadian rhythm in balance.

Keep active

Studies have shown that regular exercise can help people sleep better at night by relieving worry and anxiety

Eat well

Having a light dinner earlier in the evening and drinking enough water during the day may help people get to sleep more easily. 

It is also important to try to reduce the impact that stress may be having on sleep patterns. “The knock-on effects of stress can have a vast impact on our mental and physical wellbeing, and in particular our quality of sleep, by disrupting the balance of hormones released,” explains Samantha.

Stress-reducing strategies include talking to others, exercising, meditating, working regular hours and avoiding unhealthy habits such as relying on alcohol, smoking and caffeine as ways of coping. 

Treatment options

For customers who are looking for a product to help them sleep better, there are a variety of options available to recommend over the counter in the pharmacy. Always remember to check the label for suitability for individual customers – even with herbal remedies.

“Valerian root is a popular choice that has long been used to promote relaxation, reduce stress, and improve sleep, depending on the quantities consumed,” says Samantha.

For customers whose sleep issues are longer term, the first thing to consider is whether or not they have a clinical insomnia disorder. The RSPH explains: “If you have difficulty sleeping, three or more nights per week, for at least three months and your difficulty sleeping is troubling you, not only because of poor nights but also because of resultant poor days then you may have an insomnia disorder. This remains true whether or not you have other physical or mental health conditions.”

If a member of staff suspects a customer may have a sleep disorder, they should be referred to the pharmacist for further advice.

Insomnia disorders can be treated with prescribed medication or with cognitive behavioural therapy (CBT). Evidence suggests that both of these approaches can be helpful, but the RSPH believes the long-term benefits of CBT outweigh sleeping pills, and there are fewer side effects. In its Waking Up to the Health Benefits of Sleep report, it points out: “One in ten of us take a drug to help us sleep, and there are over 10 million prescriptions written every year in England for sleeping pills. However, CBT is the most effective treatment.”

Training and resources

To find out more about the impact of poor sleep and how to help sufferers, pharmacy teams can access a range of training materials and resources online:

Rockabye, rockabye

The Sleep Charity has many useful advice sheets on its website, including sleep advice for infants from the Lullaby Trust. The tips below are for pharmacy teams to pass onto parents worried about their infants being cold during the winter, which may be a big concern as energy bills continue to rise. These include:

  • Use more layers over thicker layers 
  • Duvets should not be used for babies under 12 months 
  • Layers should not be tucked in any higher than the shoulder
  • Hats or outdoor clothing should not be used 
  • Avoid putting the baby near a radiator, heater or hot water bottle as they cannot regulate their body temperature
  • If sharing a bed, a baby sleeping bag should be used rather than loose sheets or adult bedding
  • Pets and other children should not share a bed with an infant
  • An infants’ temperature can be checked by touching the chest and/or back of the neck. If the infant feels clammy or sweaty it means they are too hot.
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